PREMISE HEALTH OF OREGON MEDICAL P C NPI 1891450003

NPI Information

NPI: 1891450003
Provider Name: PREMISE HEALTH OF OREGON MEDICAL P C

Doing Business As: DESCHUTES JUVENILE DETENTION CENTER CLINIC

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 38D2070191

Address:
63360 BRITTA ST STE 1
BEND, OR
ZIP 97703
Phone: (541) 322-7639
Get Directions

PREMISE HEALTH OF OREGON MEDICAL P C is a multi-specialty clinic center in Bend, OR. PREMISE HEALTH OF OREGON MEDICAL P C NPI is 1891450003. The provider is registered as an organization entity type.
The provider Is Doing Business As Deschutes Juvenile Detention Center Clinic.

The provider's business location address is:

63360 BRITTA ST STE 1
BEND, OR
ZIP 97703-475
Phone: (541) 322-7639

The provider's authorized official is Jonathan Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.

The CLIA number assigned to this NPI record is 38D2070191 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/2/2021 and was last updated on 10/13/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »